Vladimir Andreevich Korshunov

Background: Pneumococcal disease is common cause of morbidity and mortality in adults and children worldwide. The severity of pneumococcal diseases determines their high socio-economic significance. Aims: Estimate the burden of pneumococcal infection and vaccination coverage in Russia. Methods: The data was obtained from federal surveillance system. The information obtained was analyzed using descriptive statistics methods. Results: The annual incidence of community-acquired pneumonia in Russia was 491.7/100000 in 2011-2019. It ranges from 359.8/100000 among adults of working age to 1505.4/100000 among children 1-2 years old. The upward trend of incidence is observed throughout the period, most expressive among school-age children (7-17 years old). Total 29.2% of all pneumonia have an identified etiology. 94% of pneumonia with known etiology are bacterial, 8.4% among it are pneumococcal. Pneumonia accounts for 57% of all deaths from respiratory diseases among children under five (3.7/100000) and 34% among elderly. The death rate from pneumonia in 2009-2018 tends to decrease. In 2018, 25.5 thousand deaths from pneumonia were registered (17.5/100000). The highest rate is observed among children under one year (14.0 /100000) and elderly (41.2 /100000). There is a downward trend in incidence of otitis media. The incidence in children under 14 was 2612.6/100 000 in 2018. The incidence of bacterial meningitis is 1.4/100 000. Every year 2-3 thousand cases are registered, 43-52% of which are among children (3.04/100000., maximally in children under one year old, 13.2/100000). The level of vaccination against pneumococcal infection is increasing annually, but the proportion of children who have received a completed course of vaccination remains insufficient (64.6% in 2019). Coverage among the adult population was 2.3% (3.8% among those over 60). The main contingents of vaccinated adults are conscripts (coverage 67.4%) and people with chronic lung diseases (coverage 15.1%). Conclusions: The socio-economic and epidemiological burden of diseases associated with pneumococcal infection in Russia remains high. Accurate assessment of morbidity and mortality rates caused by St. pneumoniae diseases isnt possible due to the insufficient level of their ethological identification. Further efforts are required to achieve high level of herd immunity against pneumococcal infection through vaccine prevention during COVID-19 pandemic.

Diseases of pneumococcal etiology are an actual problem of practical health care. S. pneumoniae continues to be one of the leading causes of serious illnesses in adults and children, such as bacteremia, otitis media, sinusitis, meningitis, and pneumonia. Vaccination is recognized as the most effective method of preventing pneumococcal infection, which is the only way to significantly affect morbidity, mortality and stop the growth of antibiotic resistance. The guidelines were developed based on an analysis of studies published over the past 5 years and included in the EMBASE, MEDLINE, PubMed databases and the Cochrane library. The results of the analysis were peer-reviewed by independent experts, taking into account the opinions of primary care practitioners. The quality and level of evidence generated, as well as the strength of the recommendations based on them, were assessed in accordance with international criteria. These clinical guidelines review the epidemiology, social significance, pathogenesis, clinical forms of pneumococcal infection, and characterize vaccines for its prevention. Recommendations for the vaccination of pneumococcal infection in children and adults, including those belonging to various risk groups and with various comorbid conditions, are presented. The target audience of these recommendations are medical specialists: pediatricians, epidemiologists, general practitioners (family doctors), therapists, allergists-immunologists, pulmonologists and others. They can also be useful for students of residency and postgraduate programs, students of advanced training courses in these specialties.

Background. The incidence of COVID-19 novel coronavirus infection has a wave-like pattern with surges in new cases followed by declines. Viral mutations, changes in viral properties, and new strains continue to emerge and are regularly reported.The aim of the study is to present a comparative analysis of clinical and epidemiological characteristics of hospitalized patients with COVID-19 during different periods of the coronavirus infection pandemic in Moscow.Materials and methods. A two-center, retrospective observational epidemiological study was performed using medical records of patients hospitalized with the confirmed diagnosis of COVID-19 in Moscow from March 2020 to March 2022 (34,354 patients).Results. Within 2 years of the pandemic, there were significant differences in the age structure of hospitalized patients. During the early months (March–June 2020) of the pandemic, age groups of 18–45 and 46–65 yearolds accounted for higher percentages of hospitalizations. Later on (July 2020 – February 2021), the proportion of older age groups demonstrated an upward trend. From spring 2021 (the emergence of the SARS-CoV-2 delta strain) to March 2022 (dominance of the omicron strain), the proportion of hospitalized working-age adults increased once again.The proportion of severe and critically severe cases among the patients hospitalized during different periods remained at steady levels: 7.7% (6.6–8.8%) and 5.5% (4.4–6.6%), respectively. The highest death rates were observed during the delta strain surge, while the lowest death rates were reported for the omicron strain. Throughout the pandemic, the older age and chronic diseases remained risk factors contributing to the severity of the disease and adverse outcomes.Conclusion. The emergence of new variants of SARS-CoV-2 causing a shift of the need for hospitalization towards younger age groups, the persistent high rates of severe cases and death rates among people of retirement age are pressing for the unfailing readiness for implementing preventive and epidemic control measures focusing on the above groups of population.

During the COVID-19 pandemic, the problem of the population's adherence to vaccination has become significantly aggravated around the world. This study is aimed at evaluating healthcare workers' (HCWs) acceptance of COVID-19 vaccination in Russia. A cross-sectional multicenter study was carried out by interviewing HCWs in Russia using an electronic questionnaire and snowball sampling. The analysis included 85,216 questionnaires from 81 out of 85 regions of Russia. Statistical analysis was performed using SPSS v.22. The results indicated that 35.0% (CI 95%, 34.7-35.3) of HCWs were ready to get COVID-19 vaccination. The acceptance level was 42.4% (41.8-42.9) for all physicians and 31.3% (30.9-31.6) for nursing staff. A total of 29.4% (29.1-29.7) of HCWs were willing to recommend COVID-19 vaccination to patients: 38.5% (38.0-39.1) of physicians, and 24.7% (24.4-25.1) of nursing staff. Acceptance of COVID-19 vaccination is higher among HCWs dealing with infectious diseases and involved in vaccination. The low acceptance of HCWs toward vaccination against COVID-19 can be explained by the low level of awareness of HCWs in these issues. Additional educational programs are needed for HCWs, both for physicians and nurses, using all possible forms and methods of education.

The analysis of the vaccine preventive status of infectious diseases in adults in Russia and various countries of the world is presented in the article. The problems and directions of improving the immunization of the adult population in Russia are identified.